| NPI | 1063761781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X (Licence: FL MH11405) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH 11405) |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2024-02-16 |